How ‘Confusion’ Over Biomechanics Can Inspire The Profession

Recently, while on a flight to attend a podiatric conference, I decided to pass the time by skimming through the pages of one of our popular podiatry magazines in the hopes that I may find some inspiration for a subject to discuss in this column. It did not take long to find something within the magazine that inspired me.

I am not talking about the type of inspiration that one may get from watching a world class athlete perform his sports specialty with amazing agility, power and speed. Rather, it was the type of inspiration that we get when we see something very wrong. It was like seeing a video clip of the same athlete being caught cheating at his sport with the disturbing actions of the individual inspiring someone to take the time to speak out against the bad behavior for the benefit of the sport.

What was so inspirational within the magazine? It was the headline in an advertisement for a foot orthosis laboratory that declared the following: “Successful Orthotics Without the Confusion of Biomechanics.”

My first thought in seeing this interesting advertisement was exactly what does the ad mean by, “Successful Orthotics Without the Confusion of Biomechanics”? If I were an internist reading an internal medicine journal and saw an advertisement that had as its banner headline, “Successful Prescribing of Medicines Without the Confusion of Pharmacology,” what would I think? If I were a structural engineer and looking through one of my engineering trade journals and saw an advertisement that claimed “Successful Structural Design of Buildings Without the Confusion of Physics,” how would I feel?

Should I just ignore this statement or should I be inspired to do something about it?

This topic of inspiration required some personal reflection. I asked myself a question, “What inspires a podiatrist to take up a cause for the profession that most of their colleagues would not even consider taking the time to speak out about?” It probably has something to do with the personality of the physician. Maybe it also has a little to do with whether the physician feels comfortable speaking out. Possibly, it is all about the ego of the doctor.

What inspires me as a podiatrist? For me, inspiration comes largely from the members of my own profession who helped train me to be a better physician for my patients. Those who were especially inspirational to me were my biomechanics professors at the California College of Podiatric Medicine. Merton Root, DPM, John Weed, DPM, Ronald Valmassy, DPM, Christopher Smith, DPM, Richard Blake, DPM, and many others guided me along toward a better understanding of foot and lower extremity biomechanics during my younger days as a student, surgical resident, biomechanics fellow and podiatrist.

My early mentors had a devotion to podiatric biomechanics and a belief that understanding biomechanics of the foot and lower extremity was critical not only to making better custom foot orthoses but also to making better surgical decisions. They inspired me to continue in their footsteps, advocating the positive health benefits that can come to the patients of those podiatrists who better understand the science of biomechanics.

Considering the current state of affairs regarding custom foot orthoses and pre-made shoe inserts, it is understandable why a company may want to bring up the subject of “confusion of biomechanics” in its marketing campaign for custom foot orthoses. Companies are selling foot orthoses, including pre-made insoles, in mass marketing campaigns on television and radio. Retail stores are dispensing “custom orthotics” from pressure mat readings. Other non-podiatric health practitioners are making “custom foot orthoses.” With all that, it is probably no wonder that many podiatrists are confused about biomechanics and its proper application in clinical practice.

Now more than ever, after a quarter century of teaching and lecturing on foot and lower extremity biomechanics and foot orthosis therapy, it is very clear to me that biomechanics should neither be confusing nor considered an optional educational concept for the podiatrist. We must continue to consider biomechanics a mainstream concept that podiatrists utilize in every patient they treat both conservatively and surgically.

Inspiration for me, in this instance, came out of my concern for my colleagues who may be confused about the relative importance of biomechanics in their own practices and may question the importance in keeping podiatric biomechanics a high priority within our podiatry schools, podiatric residencies and podiatric seminars.

Inspiration can come from many places. It is what we do with this inspiration that will make the biggest impact for the health of our profession.

Dr. Kirby is an Adjunct Associate Professor within the Department of Applied Biomechanics at the California School of Podiatric Medicine at Samuel Merritt University in Oakland, Calif. He is in private practice in Sacramento, Calif.